Professional Insurance Verifier Programme

INTRODUCTION

This Professional Insurance Verifier Programme  concentrates on the investigation and validation of short term insurance claims. The programme was developed in line with certain unit standards and the requirements of the insurance industry and how claims should be investigated.  Students will learn the finer skill of investigation methodology and how to identify insurance fraud.

WHAT WILL SET YOU APART

The main outcomes of the programme are to assist you to:

• Evaluate the instruction to verify/validate/assess an insurance claim
• Demonstrate a well-rounded knowledge base for the verification/validation and assessment of insurance claims
• Exhibit an understanding of the theoretical learning material
• Application of the theoretical learning material during the verification/validation and assessment of insurance claims
• Produce comprehensive reports based on the objective facts found during the verification process that can be defended in a court of law

IS THIS COURSE FOR YOU?

Yes, definitely yes!

This course never existed before in South Africa.

The purpose of the programme is to introduce students to the insurance industry and the specific business requirements for the verification/validation and assessment of insurance claims. Students will gain the necessary knowledge, skills and competencies to identify, analyse and solve problems relating to the verification/validation and assessment of claims to identify possible irregularities.

Course curriculum

• PIV-F 101- Introduction to and Principles of Insur…

• PIV-F 102 – How to approach an insurance verification

• PIV-F 103 – Insurable interest

• PIV-F 104 – Misrepresentation and material non-dis…

• PIV-F 105 – Dual Insurance

• PIV-F 106 – Proximate cause, perils and hazards

• PIV-F 107 – Reasonable precaution and consequentia…

• PIV-F 108 – Other policy conditions

• PIV-F 109 – Ombudsman – Test used and Prejudice

• PIV-I 201- Pre-assessment – Fraud Red Flags

• PIV-I 202 – Pre-assessment – Claims history (Motor…

• PIV-I 203 – Administration of a case file

• PIV-M 204 – Scene of incident investigation

• PIV-M 205 – Stolen vehicles

• PIV-M 206 – Accidents

• PIV-M 207 – NRTA and Driver’s licenses

• PIV-M 208 – Driving under the influence (DUI)

• PIV-M 209 – Investigative interviewing

• PIV-M 210 – Statement taking

• PIV-M 211 – Investigative Tools & Techniques

• PIV-M 212 – Validity of documentation

• PIV-M 213 – Evidence of CCTV

• PIV-M 214 – Evidence as per SA Law

• PIV-M 215 – Forced entry to vehicles

• PIV-M 216 – Motor Traders

• PIV-NM 217 – Non-motor verification

• PIV-L 218 – SA Legislation

• PIV-O 301 – Report writing

• PIV-O 302 – Insurance fraud and rejection of claims

• PIV-O 303 – Subrogation and Recovery

• PIV-O 304 – Liability claims

• Summative Assessment